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Before I start talking about hirsutism and PCOS, I’d like to remind everyone that I am not a doctor and am writing this from my personal experiences, a survey conducted with 950 women who have PCOS and a series of interviews with different electrologists and laser hair removal technicians.
I think this post is going to be one of the most embarrassing and humiliating one I’ll ever write about, but I think it’s one of the most problematic symptom that I’ve had to deal with since 2010 and I think that writing about my experiences should or may help other women out there who deal, have dealt or will deal with this.
As most of you know, this blog is primarily dedicated to food and recipes that are gluten-free, sugar-free and low carb so that women with PCOS who are interested in losing weight and taking control of their symptoms naturally can refer to them and start their low carb journey.
Hirsutism a.k.a. Facial Hair
One of the most commonly known symptoms of PCOS is weight gain, but I think the most common symptom that no one really talks about is hirsutism, most frequently known as facial hair. It’s one of the biggest struggle I’ve personally had to deal with since 2010, as well as plenty of other fellow cysters. It’s not something that any woman wants to admit. I mean having facial hair as a woman isn’t a feature that I like to boast about. I’ve seen a few women online that have gone viral for sharing their facial hair and accepting the fact that they have a beard and I applaud them. I’m so proud of them for accepting what they have been dealt with. I, on the other hand, couldn’t and still can’t. For the past 7 years, all I’ve felt was humiliation and embarrassment. I’ve never really felt very attractive or feminine because of it. I’ve never been able to accept it. Actually, I’ve accepted the fact that I have facial hair, but I’ve never been able to accept that I, as a woman, should have to endure having facial hair. For those who aren’t familiar with PCOS, when I say facial hair, I don’t mean the light blonde facial hair that every human has, I mean an actual man beard that grows on a woman’s face. It’s most commonly associated with women who have PCOS, but there are a few women that do not have PCOS, but just have higher testosterone or other hormonal problems.
The hair started to appear when my weight passed 230lbs/105kg. My insulin was through the roof, in the 40s, and my hormones were out of whack. I was about 20 years old and hair started to appear on my side burns and on my chin. At first, it wasn’t much. It was just a few hairs here and there. But as the months went by, the patches grew larger. They never fully connected, but were very noticeable as I am of Italian descent and my hair tends to be very dark and thick. I started waxing, bleaching, plucking, you name it. Anything to make it less noticeable. But it wasn’t working. The hair were there to stay. No matter what I tried, it would just grow back right away. When I turned 22 years old, I finally had enough. I had read so many suggestions online to get laser hair removal and I decided to take all of my money and go do it. I was a student at the time and I wasn’t rich or anything, but I had enough and decided to use the last of my savings for it as it was important for me to get rid of it. I needed this. I needed it to be gone so badly.
Laser Hair Removal
I booked an appointment at a laser hair removal salon soon after. The first appointment, the technician explained to me how laser worked. She told me that she treated many women with PCOS, but that I shouldn’t expect to be hair-free. Instead, I should expect that after 5-6 treatments, I should have a 70% decrease in hair growth. She then told me that laser hair removal wasn’t permanent, but it did significantly decrease the hair amount. I was happy with what I heard and decided to go ahead with the treatments.
The treatments were really painful. I cried every single time. The upper lip was the worse. I have never felt that much pain in my life. Laser shocks your skin and burns the hair instantly. One shock has a range of 1-5cm or something, I can’t really remember. After the treatments, you need to ice the area for an hour or two and put some pure vitamin E all over. The skin gets really bumpy, hot and red, but it disappears after a day or two. You’ll notice some burnt hair that will fall out after a while. You’ll notice that your skin tends to be really hot and burn for about an hour after the session. You may even get slight bruising if the laser touches a vein.
For the next year, I did about 8 sessions. Not only did the hair all come back 6 weeks after each session, but the amount of facial hair that I had basically tripled. I used to only have patches on my sideburns and my chin, but after the sessions, I had a full-on man beard connecting my side burns, neck, chin, jaw and moustache. Laser hair removal, if anything, had me feel even more worthless than I’ve ever felt. I started the treatments expecting to find a cure or some sort of relief, a slight sliver of hope that could make me feel more of a woman and make me comfortable in my own skin, regain my self-confidence and feel beautiful. These hopes were completely destroyed after a year of laser hair removal. I’d be lying if I said I wasn’t depressed and disappointed. I don’t think I had ever felt so sad in my entire life. I was so humiliated. I didn’t want to go outside, hang out with friends, and get seen by anyone whatsoever. Imagine being a woman that is supposed so look a certain way, especially the fact that being a woman in our society this day and age is already so damn hard, but being a woman that has a full grown man beard all around her face. Can you even imagine the pain and embarrassment one can have? The worst part was that the hair wouldn’t stop growing. It wouldn’t stop like leg hair at about 1cm, it would just continue to grow and grow, and if I wouldn’t have cut it, I’d probably have the Guinness world record for the longest man beard a woman can have.
The emotional roller coaster of having regrowth
At that time, I’d completely given up feeling slightly normal. I was so sick and tired of shaving, waxing, plucking and bleaching. No matter what I tried, the hair would come back the same day. I’d have a five o’clock shadow by the end of the day, irritated skin from shaving, pimples from waxing and my self-esteem had completely gone down the drain. I eventually gave up on dealing with the hair as I just didn’t have enough courage to do it anymore. It came to the point where I honestly didn’t care what other people would think of me as I, myself, had lost every ounce of respect and self-love I had for myself. I gave up on the outside world for a while, and I think from when I was about 22-24 years old, I had reached the highest level of depression one could reach and I really wasn’t in a happy place. All I could think was that no one would ever love me or look past my facial hair. All my friends knew I had facial hair, I mean it was obvious. But just the fact that they would notice or slightly look at my face for that extra second made me feel so self-conscious. It hurt me in a way where it’s been really hard for me to move forward and accept who I am and what I’ve been dealt with.
Laser doesn't work with PCOS*
After the 8th treatment was over, the laser technician told me that laser wouldn’t work on me since I have PCOS and that I should do electrolysis instead. I had used all of my money and basically had tripled the amount of hair that was on my face. I looked into electrolysis and it was just completely out of my price range. Electrolysis zaps one hair at a time and so to do a whole face can take 20+ hours of treatments and each hair follicle needs 2-10 treatments. The worst thing is that electrolysis treatments need to be regular so you can’t just skip a few months and go back. It won’t work and the hair will come back and you’ll have wasted your money. Obviously, at that time electrolysis was out of the question and out of my price range. So I completely gave up. I stopped shaving, plucking and waxing. The hair amount was just so ridiculous that anything I tried was just making it worst. My skin felt so sensitive and irritated that I had just enough. I decided to let the hair grow out and just bleached them. I was tired of the pain of pulling each hair out of my skin 2-3 times a day just so that I could feel like a woman, so I just let it grow out. I think I had the long facial hair for about 2 years. Everyone noticed. Obviously my friends didn’t treat me differently, but they did notice and so did strangers.
*Looking back, laser may have been more effective if my hormones and insulin were at normal levels like today. I think the reason laser didn't work is because my insulin was in the 40s, whereas it's 7 today, my male hormones were too high and my female hormones, LH and FSH, were irregular, whereas they're all normal today. But I think that because my hormones and insulin were out of whack, laser did not work. However, I can't say for sure that it was because of that. I definitely think it was one of the main factors that made it unsuccessful. If perhaps my hormones and insulin would have been normal, it may have been successful, but because my experience was negative, I can't recommend laser to anyone.*
For those two years, I had gone to a few electrolysis clinics in Ottawa and Toronto to see what it was like and how it felt. I had explained to them that I did laser and that it had tripled the amount of hair I originally had. She told me that laser really shouldn't be done anywhere where hormones are sensitive. Hair that grows on the face, under the belly button, on your bum, between you thighs or behind you upper arms are all very sensitive to hormones, whether male or female, and so having laser done on those hair follicles only stimulates the dormant ones to come out even more because it zaps a wide area and touches the ingrown hair too. I think I went 4 times total to electrolysis because I didn’t really have the funds for it. But my goodness. Laser is painful, yes, but at least it’s quick. I hadn’t realized that doing electrolysis would take so much time. The way electrolysis works is that they insert a tiny needle into the hair follicle and zap the root of the hair with an electric current for 1-10 seconds depending on the machine and the electric current it’s set at. The shock can be a little painful to ridiculously painful. The electrologist will adjust the power according to your pain reaction. I’ve read that the stronger the power, the better because that way the root of the hair can be sure to be burned. However, it’s not like you can suddenly withstand a super strong electric shock 300 times on your face for an hour. There’s a limit to how much pain one can handle and my pain tolerance isn’t really high.
Try out different clinics
I tried four different electrolysis clinics and let me tell you something. Before you decide on a clinic to continue your treatments for the following number of years, TEST out the electrologists. I do not mean to be rude, but electrolysis needs to zap one hair at a time meaning that the treatments will take an enormous amount of time. We have over a million hair on our faces and zapping one hair can take 1-10 seconds. I don’t deny that electrologists know what they’re doing, but the speed they do it at is important. Time is money, especially for electrolysis. I tried four different clinics and I swear some took so much time compared to other clinics that I honestly thought they were doing it on purpose so that they could get more money out of me. So definitely try out different places and see which one gets the job done fast. If you go to a slow clinic and don’t check out other ones, your treatments will cost SO much more over the years so definitely be careful with that. I once counted how many hair this one electrologist zapped in 45 minutes and she zapped about 400 something. When I went to a slower electrologist, she had zapped about 100 in the same amount of time.
Time is money
In addition, the equipment used is extremely important. The fast place used a bright light that would go over my face so that she could see all the hairs, plus she had these mini magnifying glasses that would make her see all the tiny hairs and make sure to zap every one of them. She also held the tweezers and needle in one hand and used her other hand to stretch out my skin to get access to all the hair. Also, she sat on a lower chair while I was lying on a bed and she was crouched over me so that she could see everything. On the other hand, at the slowest place, the electrologist didn’t used any magnifying glasses, and she stood up so her face wasn’t close to my face. She couldn’t see the hairs as well, thus the reason why she was slow. After one treatment with her, I decided that it was a huge waste of money and also my precious time because she wasn’t competent enough. So honestly make sure your electrologist is fast. It is SO important.
Patient or bag of money?
Another important thing to consider is whether the electrologist treats you like a patient or a bag of money. I felt that the electrologists that would put a timer, check the time every second or try to make me sign a contract that said to come at least two times a week as a client or she wouldn’t be able to treat me were being unfair and were thinking of getting paid more than treating me. I honestly did not like that as I knew that I would be doing treatments for a long time and wanted an electrologist that I could trust and that wasn’t just in it for the money. The one I go to now schedules me for a session of however long and sometimes pass the time scheduled by 2-10 minutes and she never charges me. I think she knows that there is a lot of work to do and she treats me more like a human being, rather than a bag of money. She always makes sure that whatever area we're doing that day is completely hair free.
I got a job! = I can pay for electrolysis
In January 2015, I moved to Japan because I got a job there and was officially employed. That meant that I could finally afford electrolysis treatments. I was not interested in laser as it had ruined my face and made the hairs grow like crazy, so I definitely wanted to invest my time into electrolysis. If you’ve read my ‘About Me’ page, you’ll know that the second I moved to Japan, my periods magically came back and have been regular ever since. Electrolysis isn’t very popular in Japan so finding a clinic was a bit hard. I actually have to go into Tokyo (I live in Saitama, another prefecture) and it takes about an hour and a half each way.
The first time was just like the other clinics. They explained how electrolysis works and give you a free trial for 10 minutes. Because I had already done electrolysis before, I told her I wanted to buy an hour right away and do a treatment. She used a different kind of machine (there are so many varieties btw) where I held a metal stick and she would zap each hair for a minimum of 10 seconds. She said she prefers to use this machine and zap for a longer periods because she's seen more success zapping for a longer time than for a shorter time. She has a big light over my head, a magnifying glass and sits right beside me so she’s crouched over my body so she sees all the hair. I love her because she never puts a timer and we just talk while she does the treatments. Every clinic is different in terms of prices. I think Japan is on the higher end for it. You can buy minutes or you can buy a 5 hour package. Other clinics will sell bigger packages too, but she’s the cheapest one I’ve found so far and love her. A 5 hour package in Japan costs 61000¥ (540$) so you can see that it can get pretty pricey. I decided to do 45 minutes treatments per week because one, I couldn’t afford more and two, it hurts soo much that I cannot handle more than 45 minutes. I would've liked to go twice a week, but I could only afford once a week for 45 minutes so that’s what I started with.
If you look at my chart (sorry I only started the chart in May 2015 and not January), you can see that I started with 3-3.75 hours per month, decreased to 2 per month, then to 1 per month and now I do 30 minutes per month. My chart also includes my weight, what days my periods came and how long between each period. The black sections are because my periods overlapped between 2 months. In January 2016, I got my periods on the 30th until the 3rd of February and then again on the 6th of March.
You can check out my latest health update to see where my insulin levels and hormones are!
I started the treatments with my long hair bleached because I had stopped waxing. Because I had so much hair, we decided to start section by section or else we’d get confused as to where we had done and where to redo, etc. I asked her to do my chin first because that was the place I hated the most, then she moved to my sideburns, then my cheeks and then my jaw and neck. By the way, she didn’t go over those places in one treatment, I mean in the course of 20 or so hours, she went through all those sections one by one, while going back to previous sections to zap the hair that had come back. My face wasn’t clear, or semi-cleared until about November 2015. I think I finally started to look like I had no beard around that time, but the hair would come back so I still had to go every week or every two weeks.
While she focused on eliminating the hair on a particular section, I would still have hair on the other sections and I was fine by that. You have to remember that once you start electrolysis, you CANNOT shave, pluck or wax the hair as you’re just going to ruin everything and the hairs WILL come back. You can trim and bleach, but under no circumstances should you pluck the hair out of your face. It’s a pretty crappy part about it, but I learned to live with the hair and I’m finally seeing results.
Hormones & Insulin
It is important to note that all women produce the male hormone testosterone, but in much smaller amounts. This is one of the hormones that causes facial hair, among other ones. Excess facial hair depends entirely on several factors: the hair follicles' androgen sensitivity, genetics (people from the Middle East or Mediterranean tend to have more hair), insulin sensitivity, testosterone levels, and hormones like estrogen and progesterone. If you have a poor diet and have consumed high amounts of carbs like sugar and refined carbohydrates, your body most likely started becoming insulin resistant over the years. When that happens, your body is unable to process sugars properly or break down food. This unfortunately has a major impact on hormone levels which can cause hair to grow. A diet that is high in carbohydrates raises insulin levels, which in turn raises testosterone levels and other female hormones, which can contribute to an increase in facial hair. High testosterone can also cause acne and scalp hair loss. As long as your hormones are out of whack and your insulin is too high, hair WILL grow. Essentially, you CANNOT do electrolysis or laser if you do not have your insulin and hormones under control. The hair that you zap will not only come back, but dormant hairs will also come out. I recommend checking out my guide on how to start a low carb diet for getting those hormones in control.
How long should it take?
I found this really helpful article here that talks about how many hours or years you should expect to get rid of facial hair. It’s an article specifically designed for transsexuals, but they go through the same thing as women with PCOS.
Factors to consider
- An important factor to remember is that electrolysis WILL TAKE TIME, even years. You should expect treatments to take from 1 to 4 years or more. According to the article, the average is 2 years and the fastest has been 10 months. Completion requires from 40 hours to more than 700. The treatments NEED to be regular, and by that I mean every single week. The biggest financial challenge will be to get your face cleared, after that it’s just zapping the hairs that come back. For me, personally, it took 10 months-ish to clear my face after going there once a week. It can obviously take less time if you have the money, but for my case, it wasn’t. After your face is cleared, then you can start going for less time or just 1-3 times a month depending on how much hair comes back. I've been going for 2.5 years now.
- I think the most important thing to remember is that if you do not have your hormones and insulin under control, the hair WILL come back. Before even starting treatments, you need to get your female and male hormones and insulin under control, either by diet and exercise or by medication. If they aren’t in control, the hairs will always come back, unfortunately.
- You need to be patient. It won’t happen overnight. It’s almost been three years for me and I now go once a month instead of once a week. The hair is barely noticeable, but a few do come back. The hair on my neck and jaw are coming back first because that is the last section that I started. The hair on my chin was the section I had started with and I haven’t had hair there for a good year now. I get occasional hair on my sideburns and cheeks, but most of it is on my jaw and neck. I just started doing the upper lip because it's one of the most painful area to treat and I've been avoiding until now. I started the upper lip in June 2017. I can only handle about 5 to 10 minutes on the upper lip and then I start crying. Even if the hair decides to stick around for the rest of my life, going once a month for touch ups instead of once week is definitely a life savour and I'll take that any day.
- It will hurt. I find that the treatments during my periods or right before my periods are the most painful. Maybe because I’m extra sensitive during those days, but I try to schedule my appointments at times where I will not be on my periods. I also take an Advil one hour before each treatment. There are a few creams you can use before treatments (Maxilene and Emla) that sort of numb your face, but they can be quite pricey and honestly I’ve never noticed a difference with or without them so I just stick with my Advil. I've been told that getting your face frozen after going to the dentist is a godsend since you don't feel anything and can do 2+ hours without pain, but I obviously can't do that every month lol.
- Your diet will affect the growth of the hair. Make sure to eat healthy and exercise as eating sugar or gluten will affect the hair and they will come back faster. In April 2016, I had an ACL surgery on my knee because I broke it a few months before. Anyway, I was hospitalized for three weeks and couldn’t bring any food in the hospital. I had to eat what they gave me for three whole weeks. I had been eating gluten-free, sugar-free and low carb for the past year and I suddenly had to eat wheat and rice every single meal for three weeks. At that time, I used to go do treatments every 2 weeks for 30 minutes for the past 4 months, but when I was hospitalized, the hair came back after a week and double the amount that normally comes. I had to go do electrolysis 3 times that month because I had eaten carbs, gluten and sugar for three weeks, also because I was stuck in bed and wasn’t moving. Ever since, I’ve been very careful about what I eat and the hair growth has decreased over the months. You'll also notice that eating low carb can lighten the hair colour.
After three years of treatments and seven years of having facial hair, I finally look like a woman again. A few of the hairs do come back in some random places, but I go do touch-ups once a month and then it’s all good again. You can see in the pictures below the hair before the treatment, the hair right after, and the hair growth 3 weeks after. Compared to two years ago, I think it’s absolutely incredible.
The Unfortunate Truth
I just want to say that it is extremely important that you remember this. And I don't mean to be cruel or mean, but just want to say the unavoidable truth. As humans, we all have blonde baby hair. The hair is in its dormant form. If your hormones are out of whack or if your insulin is too high, those blonde hair follicles will come out of their dormant form and turn long and black. Once the facial hair has come out and grown dark and black, there is no way to remove it, unless permanently removed. By that I mean, no matter how much vitamins or medication you take, no matter how healthy you eat or how much you exercise, once the hair is out, it's out. It doesn't matter if you pluck, wax, trim or shave, the hair will come back. Think about it. If you were to pluck your hair on your head, it will come back. The hair follicle has been created so even if you pluck it out, the hair will simply grow back because the hair is not dormant anymore. So you may think that eating healthy is not important, but it is. By eating healthy, exercising and eating low carb, you are controlling the amount of insulin your body makes. By having a normal amount of insulin, your hormones start to become normal and so do your insulin levels. So eating healthy makes the baby blonde dormant hair that hasn't developed into long and dark hairs stay that way, stay dormant and not come out. But the hair that had come out previously from your hormones or extra insulin will unfortunately always be there unless permanently removed. Since hair starts to appear with PCOS' extreme levels of hormones and insulin, there is no way to remove the hair follicles once the hair has come out, unless you do permanent hair removal ONLY IF YOUR HORMONES AND INSULIN ARE NORMAL.
The treatments in pictures
Here are some pictures of treatments I had this year so you can see how hair growth works. I don't really have hair on my sideburns, cheek and chin anymore. It's all in the neck and under my jaw as it's the last area I started. I started the moustache area in June 2017 so still have hair because we haven't cleared the entire are yet.